Phakathi kwezifo ze-urinary system, i-reflux ye-vesicoureteral ivela rhoqo. I-pathology ichaphazela kakhulu abantwana kunye nabantu abadala. Ukuxilongwa kuyinkimbinkimbi ngokungabikho kwempawu ezicacileyo kwiinqanaba zokuqala zokugula.
Yintoni i-reflux ye-vesicoureteral?
I-reflux ye-bladder-ureter idla ngokubizwa ngokuba yi-disorder apho i-current reverse urine ivele khona. Ukuhlaziya umchamo, ukudluliselwa kwi-ureter kunye neentso zenziwa phantsi koxinzelelo, okuphazamisa ukusebenza kwe-valve ye-vesicle ye-ureter. Oku kwenzeka njalo emva kokuba i-vestile igqithise, ngenxa yoko, ekuhambeni kwexesha, kukho ukutshintshwa kwimeko yelungu.
Ngokuqhelekileyo, uxinzelelo olwandayo kwi-bladder njengoko luzalisa kufuneka luvalize ivalve. Nangona kunjalo, nge-reflux, le nto eyenziwe yonakaliswe okanye iyancipha, nto leyo ibangela ukuhlaziywa kwamanzi emzimbeni. Ukukhupha umchamo kunokubakho kokubili ngexesha lokulungisa kunye nangethuba lokuzaliswa kwesitya. Isifo ixesha elide asibonakali kwaye sithotyelwa xa sihlola izigqeba ezincinci.
I-reflux ye-vesicoureteral
Ngolu hlobo lwesifo, umchamo we-urlu uvele kuphela ngexesha lokuchama. Iimisipha zesikhumba ziza kwithethini, ngenxa yoko, umchamo uthululwa kwi-ureters kwaye uqhubele phambili kwiintso. Ngxeshanye, ikwabiwe ngaphandle. Ngaloo mntu uvakalelwa kukungahambi kakuhle kwintsimi yecala, kwicala. Le fom ye-pathology ingenxa yokungafaneleki kwevaji ekhoyo kwi-vesicle ye-ureter, ebonakalayo ngexesha loviwo olubanzi.
Reflux ye-vesicoureteral
I-reflux encinci ibhekisela ekutshintsheni umchamo kwi-bladder kwi-ureters, eyenzeka ngexesha lokuzalisa umzimba. Ngale ndlela yokukhubazeka, ukungakwazi ukuvelisa i-valve kuthethwa kakhulu, ngoko ukungena kwe-urine kwi-ureters kunye neentso kubakho rhoqo. Umthamo we-urine ubuyela emuva ngenxa yezinga lokukhubazeka, isivumelwano sokwenza isivumelwano kunye nesimo se-valve ngokwawo.
I-vesti / i-refrex ye-refrex ibangela
Ngokuxhomekeke kwithuba lokuphuhliswa kwesifo, i-reflux ye-vesicoureteral ye-primary and secondary is isolated. Ifom yokuqala yentsholongwane kuthiwa xa isifo sisiphumo sokuzalwa esingumntwana kwaye senziwa kwinqanaba lokuphuhliswa kwe-intrauterine-reflux ye-vesenourraretical congenital. Uxinzelelo olwandayo kwi-bladder ngokulungelelaniswa okwaneleyo kwimizi-mboleko ye-ureteral kukhokelela ekuphuleni, kubangela umchamo we-reflux, izibangela zazo zibe zilandelayo:
- ngokuphindwe kabini kwe-ureter;
- i-dystopia yomlomo;
- ukukhawulwa komlomo;
- I-tunnel emfutshane ye-submucosal ye-intravesical ureter.
Ifom yesibili ye-reflux ye-vesicoureteral ivela malunga nemeko yeemeko zesifo se-urinary. Phakathi kwezizathu eziqhelekileyo:
- isakhiwo se-urethra;
- i-stenosis entanyeni yesikhumba;
- i-adenoma yeprostate;
- i-cystitis ;
- ukuxubha kwesibindi;
- umonakalo kwi-orifice ye-ureteric ngexesha lotyando.
Iimpawu ze-reflux zamakhadidi
I-symptomatology yesifo isoloko ifihliwe. Kwimimandla enokwenzeka, kodwa ingekho imimiselo yesi sifo, oogqirha banikela ubuhlungu obuhlungu, obuhlungu buhlungu emqolo ongaphantsi, obonakala ngokukhawuleza emva kokuba i-vestile isuswe. Abantwana banokubangela intlungu kwisisu esisiswini, i-groin.
Iimpawu zesifo zibangelwa yinqanaba lenkqubo yesifo. Ngokuqhelekileyo, yonke into ixhomekeke kwinqanaba lokuphuhliswa kwe-reflux ye-vesicoureteral, iqondo eliya kuba lilandelayo:
- Iqondo eli-1 - umchamo ubuyela kwi-ureter, awufikeli i-pelvis;
- I-degree 2 - i-reflux ifinyelela kwiintso;
- I-3 degree - i-dilre dilates;
- Iqondo le-4 - ijometri yephepha lomchamo iphazamiseka, i-crimp ivela;
- Iqondo elingu-5 - i-parenchyma yamaphuzu aphantsi, zonke iinguqulelo zingentla zikhoyo.
Izikhalazo ezivela kwizigulane oogqirha zivame ukuva kuphela ngokuphuhlisa i-pyelonephritis. Kule meko, kubonakala:
- ukwanda kweqondo lomzimba;
- intlungu yesisu;
- ukuwohloka kweentlalo-ntle;
- i-clouding yomchamo.
Kwiimeko ezininzi, i-PMR ifunyenwe kuphela kwinqanaba lokuphuhliswa kweengxaki kunye nezinye iziphazamiso, phakathi kwazo:
- i-cystitis ephindaphindiweyo (ngokukhawuleza ukuvuthwa kwe-urinary kwiincinci ezincinci);
- i- pyelonephritis engapheliyo (isicatshulwa, isicatshulwa esifanelekileyo kwingingqi ye-lumbar, izinga lokushisa alikho ngaphezulu kwama-38 degrees);
- enuresis.
Isambatho kunye ne-refrex ye-refrex - ukuxilongwa
Kwikhondo eliqhelekileyo lokuxilongwa kwe-reflux ye-vesicoureteral, i-ultrasound yeentso kufuneka isetyenziswe. Uphononongo lunokuqhutyelwa nangaphambi kokubonakala komntwana (u-reflux oyintloko). Ukubonakaliswa koviwo olupheleleyo lwe-urological kungabonakaliswa kweeplavis (kwindawo ejikelezayo engaphezulu kwama-5 mm). Uviwo olubanzi ukuba kukho ukusola kwi-pathology kufuneka zibandakanye ezi zilandelayo zifundo:
- iindlela zelabhoratri: uhlalutyo lomchamo jikelele, uvavanyo lwegazi, inkcubeko yebhakteria;
- i-radiosotope i-renography;
- nephroscintigraphy enamandla;
- uroflowmetry;
- utywala o
- Mikrotsionnaya cystourethrography;
- i-cystoscopy.
I-chlamydial reflux - unyango
Ukukhuphela i-reflux ye-vesicoureteral, unyango lwezokwelapha lujoliswe ekupheliseni izinto ezimbini ezilimazayo:
- impembelelo ye-hydrodynamic ngenxa yokunyuka kwengcinezelo kwisitya;
- ukutheleleka kwamathambo okuphindaphindiweyo.
Ngaliphi na izinga lokuphazanyiswa, ukungenelela kwezilwanyana kuqalisa ngeendlela ezikhuselekileyo eziquka:
- Ukulungiswa kweziphazamiso zesisombululo kwi-bladder kunye ne-ureter (iPikamilon, Elkar).
- Ukuthintela nokunyangwa kosulelo lwe-genitourinary system - uroseptics , antibiotics, phytotherapy (iTetracycline, Metronidazole, Ciprofloxacin).
- Ukupheliswa kokuphulwa kwe-urodynamics.
I-reflux ye-Bladder-ureteral - ingcebiso yeklinikhi
Ukuba ukubuya komchamo kungenxa yokugula kwe-orifice ye-ureteral, yindlela kuphela yokuyiphatha. Kulo xesha, ukubuyiswa komsebenzi we-valve we-ureter kuqhutyelwa ngokutshintshela izicubu kunye nokwenza i-valve ngendlela yokwenza izinto. Nge-MTCT yesibini, unyango oluchanekileyo lwezifo ezibangele i-disorder (izifo zokuvuthwa kwe-urinary kunye ne-urinary, i-bladder dysfunction) iyadingeka. Ubunokwenzeka bokusalala kwesifo emva kokupheliswa kwezinto ezinokubangela ukufikelela kuma-70%.
Ukulungiswa kwe-endoscopic ye reflux ye-vesicoureteral
Ngaphandle kokungabikho kwindlela yokwelapha okulondolozayo, xa kungenakwenzeka ukuphelisa i-reflux ye-vesicoureteral, ukusebenza kuyindlela yokuphela yonyango. Ngokuqhelekileyo, indlela endoscopic isetyenziswa. Ngokusebenzisa i-lumen ye-ureters, ngaphandle kokuboniswa kwesikhumba, ukufakelwa kwe-gel kufakwe kwingingqi engabonakaliyo ye-ureter. Yenza i-tubercle, eyenziwa njenge-valve, ekuthintela ukutshintshwa kwe-urine kwi-vestile kwi-ureter.